PRIAPISM AS A COMPLICATION OF PSYCHOPHARMACOTHERAPY

2020 ◽  
pp. 33-43
Author(s):  
Andrey V. Golenkov
Keyword(s):  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
First Generation ◽  
Selective Serotonin ◽  
Elderly Men ◽  
Stabilizing Agents ◽  
Daily Dose ◽  
Female Version ◽  
Almost All ◽  
Injectable Form

Priapism is a serious complication of psychopharmacotherapy, which can result in erectile dysfunction if there is no timely diagnosis and treatment. Purpose: to study cases of priapism in patients taking psychotropic drugs which were described in the literature. Articles were searched in the Medline database (1969-2020) in English by keywords – priapism and psychotropic drugs. 265 articles were found, most of which were devoted to the use of trazodone (81 articles) and resperidone (50) in patients with mental disorders with the development of priapism. There were cases of such complication associated with taking 12 antipsychotics (six – of the first generation and six – of the second; three – drugs of prolonged action) and 12 antidepressants (from the group of tricyclic, tetracyclic, selective serotonin and dopamine reuptake inhibitors, monoamine oxidase inhibitors, serotonin and norepinephrine reuptake antagonists/inhibitors, selective serotonin reuptake inhibitors), as well as four mood stabilizing agents. The prescribed doses of drugs varied widely. Often these medications were used in various combinations. Priapism most often occurred in the first days (month) of treatment with low doses of drugs. Cases of priapism against the background of psychopharmacotherapy are described not only in adults and elderly men, but also in children starting from the age of two, as well as in women who developed clitorism (female version of priapism). Although priapism is caused by many factors, caution should be exercised when adding other psychotropic drugs to treatment, when increasing their single (daily) dose, passing from the tablet to the injectable form, including appointment of depot drugs, and canceling treatment. Special attention should be paid to patients having episodes of prolonged erections and hematological pathology (hemoglobinopathies and thrombophilias) in their medical history. Priapism is a rare but dangerous complication that requires urgent urological care. This condition can develop when taking almost all psychotropic drugs that have serotoninergic, dopaminergic and alpha-adrenergic antagonistic properties.

The Impact of Trends in Psychotropic Prescribing on the Method of Suicide in the Elderly

2005 ◽  
Vol 45 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Ajit Shah ◽  
Lubbaba Lodhi
Keyword(s):  
Psychotropic Drugs ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
The Elderly ◽  
Serotonin Reuptake Inhibitors ◽  
Prescribing Patterns ◽  
Selective Serotonin ◽  
Hypnotics And Sedatives ◽  
Suicide Rates ◽  
Elderly Suicide

Suicide rates in the elderly have declined in many countries in recent years. This decline has been reported to be associated with increased prescribing of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), antipsychotics and antimanic drugs and reduced prescribing of barbiturates, hypnotics and sedatives. This study examined the relationship between prescribing patterns of individual psychotropic drugs and suicide rates by specific methods of elderly suicides. There was a negative correlation between the prescription of tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics, antimanic drugs and non-opiate analgesics and a decline in elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. There was a positive correlation between the prescription of barbiturates, hypnotics and sedatives and elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. This study demonstrated that changes in prescribing patterns of individual psychotropic drugs do influence elderly suicide rates of the commonly used methods of suicide and suggest that this may be due to more accurate diagnostic-specific prescribing of psychotropic drugs.

Psychotropic Drugs Involved in Serious Intentional Drug Overdose

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Tournier ◽  
A. Grolleau ◽  
A. Cougnard ◽  
N. Moore ◽  
H. Verdoux ◽  
...  
Keyword(s):  
Psychotropic Drugs ◽  
Drug Overdose ◽  
Selective Serotonin Reuptake Inhibitors ◽  
First Generation ◽  
A Priori ◽  
Mood Stabilizers ◽  
Cardiac Massage ◽  
Final Model ◽  
Confounding Variables ◽  
And Gender

Objectives:To describe the types of psychotropic drugs ingested during intentional drug overdose (IDO) in subjects consecutively admitted to an emergency department and to assess which ones were a prognostic factor associated with increased morbidity during hospitalization.Methods:Demographic characteristics, psychiatric history, current drug treatment, characteristics of the IDO were collected for 1654 patients admitted for IDO with psychotropic drugs (anxiolytics, hypnotics, antidepressants, antipsychotics and mood stabilizers). IDOs were a priori categorized as serious if associated with at least one of the following outcomes or technical events: death, hospitalization in the ED longer than 48 hours, respiratory support, use of vasopressive drugs, cardiac massage or dialysis. All types of psychotropic drugs were entered into a logistic regression model adjusted for age and gender. A stepwise selection was used to assess the types independently associated with serious IDO. Then, numerous confounding variables were entered one at a time in the final model.Results:Nearly all the patients ingested psychotropic medications during the IDO (88.4%), most often benzodiazepines (71.6%), and half used at least two various psychotropic products. Serious IDO was associated with tricyclics (OR 5.7; 95%CI 3.3-9.8), lithium (OR 4.3; 95%CI 1.6-11.6), carbamates (OR 2.7; 95%CI 1.8-4), anticonvulsants (OR 2.4: 95%CI 1.4-4.3), first-generation antipsychotics (OR 2.4; 95%CI 1.7-3.5) or selective serotonin reuptake inhibitors (OR 1.6; 95%CI 1.1-2.3).Conclusion:Some drugs may be dangerous because of low toxic doses; prescriptions of short duration may be recommended. Moreover, for safety reasons, prescribers may prefer SSRIs to tricyclics and benzodiazepines to carbamates or phenothiazines.

scholarly journals Psychotropic drug-induced hyponatremia: results from a drug surveillance program–an update

2021 ◽  
Author(s):  
Johanna Seifert ◽  
Martin Letmaier ◽  
Timo Greiner ◽  
Michael Schneider ◽  
Maximilian Deest ◽  
...  
Keyword(s):  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Sodium Concentration ◽  
Electrolyte Imbalance ◽  
Selective Serotonin ◽  
Surveillance Program ◽  
Drug Surveillance ◽  
Angiotensin Ii Receptor ◽  
Drug Induced ◽  
Converting Enzyme Inhibitors

AbstractHyponatremia (HN) is the most common electrolyte imbalance (defined as a serum sodium concentration Na(S) of  < 130 mmol/l) and often induced by drugs including psychotropic drugs. AMSP (Arzneimittelsicherheit in der Psychiatrie) is a multicenter drug surveillance program that assesses severe or unusual adverse drug reactions (ADRs) occurring during treatment with psychotropic drugs. This study presents data from 462,661 psychiatric inpatients treated in participating hospitals between 1993 and 2016 and serves as an update of a previous contribution by Letmaier et al. (JAMA 15(6):739–748, 2012). A total of 210 cases of HN were observed affecting 0.05% of patients. 57.1% of cases presented symptomatically; 19.0% presented with severe symptoms (e.g., seizures, vomiting). HN occurred after a median of 7 days following the first dose or dose increase. Incidence of HN was highest among the two antiepileptic drugs oxcarbazepine (1.661% of patients treated) and carbamazepine (0.169%), followed by selective serotonin-norepinephrine reuptake inhibitors (SSNRIs, 0.088%) and selective serotonin reuptake inhibitors (0.071%). Antipsychotic drugs, tricyclic antidepressants, and mirtazapine exhibited a significantly lower incidence of HN. The risk of HN was 16–42 times higher among patients concomitantly treated with other potentially HN-inducing drugs such as diuretic drugs, angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and proton pump inhibitors. Female SSNRI-users aged  ≥ 65 years concomitantly using other HN-inducing drugs were the population subgroup with the highest risk of developing HN. The identification of high-risk drug combinations and vulnerable patient subgroups represents a significant step in the improvement of drug safety and facilitates the implementation of precautionary measures.

Psychopharmacology in medical practice

2020 ◽  
pp. 6465-6470
Author(s):  
Philip J. Cowen
Keyword(s):  
Psychiatric Disorders ◽  
Medical Practice ◽  
Psychotropic Drugs ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antipsychotic Drugs ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Medical Conditions ◽  
Antianxiety Drugs

Drugs intended to treat psychiatric disorders are referred to as psychotropic drugs. The main categories are antidepressants, mood stabilizing drugs, antipsychotic drugs, and antianxiety drugs. These drugs are widely used in medical practice and most clinicians are likely to have under their care several patients receiving treatment with them. Practitioners therefore need to have an understanding of both the uses and unwanted effects of psychotropic drugs, and particularly of (1) their interactions with drugs used to treat other medical conditions, (2) characteristic abstinence syndromes that can occur with sudden discontinuation of antidepressants (particularly selective serotonin reuptake inhibitors and venlafaxine) and anxiolytics.

Sign in / Sign up

Export Citation Format

Share Document